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1 General aspects (0)   1.1 Epidemiology (5)   1.2 Population genetics (1)   1.3 Pathogenesis (10)   1.4 Quality of life (6)   1.5 Glaucomas as cause of blindness (3)   1.6 Prevention and screening (4) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (1)   2.2 Cornea (9)   2.3 Sclera (1)   2.4 Anterior chamber angle (2)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (6)     2.5.2 Schlemms canal (2)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (3)       2.6.2.1 Trabecular meshwork (0)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (5)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (0)   2.9 Ciliary body (1)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (3)   2.13 Retina and retinal nerve fibre layer (6)   2.14 Optic disc (10)   2.15 Optic nerve (1)   2.16 Chiasma and retrochiasmal central nervous system (1)   2.17 Stem cells (0)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (3)   3.2 Electron microscopy (1)   3.3 Immunohistochemistry (10)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (13)     3.4.2 Gene studies (6)   3.5 Molecular biology incl. 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Abstract #11821 Published in IGR 7-1

Clinical implications of peripapillary atrophy in glaucoma

Jonas JB
Current Opinions in Ophthalmology 2005; 16: 84-88

See also comment(s) by Erik Greve •

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PURPOSE OF REVIEW: To elucidate peripapillary atrophy in glaucomatous optic neuropathy; its ranking in the morphologic diagnosis of the glaucoma, and its value for the differentiation of various types of chronic open-angle glaucoma, for the separation of glaucomatous eyes from nonglaucomatous eyes, and for the detection of progression of glaucoma. RECENT FINDINGS: Recent studies showed an association of peripapillary atrophy with glaucoma and the eventual development of glaucomatous disc hemorrhages independent of a small neuroretinal rim area, and an association between increasing peripapillary atrophy and progressive glaucoma. A ranking of optic disc parameters to detect glaucomatous damage revealed that the alpha and beta zones of peripapillary atrophy, compared with neuroretinal rim parameters, are less useful. Pseudoexfoliation syndrome without glaucoma is not a risk factor for peripapillary atrophy. In arteritic anterior ischemic optic neuropathy, peripapillary atrophy does not enlarge. Peripapillary atrophy does not differ markedly between Europeans and South Indians. In contrast to the position of the central retinal vessel trunk, the presence and position of cilioretinal arteries do not markedly influence the progression of peripapillary atrophy in glaucoma. SUMMARY: Peripapillary chorioretinal atrophy is one among several morphologic variables to detect glaucomatous abnormalities. Ranking optic disc variables for the detection of glaucomatous optic nerve damage, peripapillary atrophy is a variable of second order. It is useful for the differentiation of various types of chronic open-angle glaucomas. In contrast to glaucomatous eyes, eyes with nonglaucomatous optic nerve atrophy, including eyes after arteritic anterior ischemic optic neuropathy, do not show an enlarged peripapillary atrophy.

Dr. J.B. Jonas, Department of Ophthalmology, Faculty for Clinical Medicine Mannheim, Ruprecht-Karls-University Heidelberg, Germany

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Classification:

2.12 Choroid, peripapillary choroid, peripapillary atrophy (Part of: 2 Anatomical structures in glaucoma)

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